The Children.

Question 1

Infant with diffuse desquamating rash

Answer 1

SSSS - staphylococcal scalded skin syndrome, check the umbilical stump for infection

Nikolskys sign - large flaccid blisters that extend with pressure

Question 2

Tx for otitis media

Answer 2

Amoxicillin - move to Amox-Clav if not resolving, or if recently to with abx

Question 3

Purpura in a child with normal blood work results with abdo pain and arthralgia

Answer 3

Immunoglobulin A Purpura (previously H-S purpura)

Question 4

Abdo pain/ early satiety - progressing GI sx and rapid wt loss must rule out

Answer 4

SMA syndrome - there the SMA compresses the duodenum

Question 5

What hormone may be elevated in Turners after age ten

Answer 5

FSH (they will have low estrogen and elevated LH as well)

Question 6

Most common complication of HiB meningitis?

Answer 6

Sensorineural hearing loss

Question 7

Bulging fontanelles

Answer 7

Meningitis - might not have nuchal rigidity

Question 8

Still’s murmur

Answer 8

Mid-LSB, mid systolic, a diastolic murmur is more suggestive of pathology

Question 9

Why no ceftriaxone under 1 month

Answer 9

Can cause liver enzyme increases

Question 10

Fluid status physical exam on a baby

Answer 10

Fontanelles, weight, sunken eyes/ tears, mucus membranes, tachycardia, cap refill, activity, turgor and mottling

Question 11

Most common cause of eye infection for newborns

Answer 11

Chlamydia

Question 12

What is Spondyolysis

Answer 12

Defect of pars interarticularis. -stress fracture due to chronic hyper extension - adolescent athlete. Evaluate first with an X-ray

Question 13

Adolescent with bilateral lower lobe pneumonia

Answer 13

Mycoplasma is common in youths CAP

Question 14

Bleeding reddish/blue mass in nose of child

Answer 14

Juvenile Nasopharyngeal Angiofibroma

Question 15

Initiating puberty in Turner’s syndrome

Answer 15

Give estrogen, then add progesterone once menarche is obtained

Question 16

Palpable purpura on a child?

Answer 16

Immunoglobulin A vasculitis (H-S purpura)

Question 17

Features of Fragile X

Answer 17

Prominent jaw, forehead, thin face with protuberant ears, intellectual disability

Question 18

Tx for absence seizures

Answer 18

Ethosuximide

Question 19

Kid with anemia and AKI after a stomach flu like illness

Answer 19

Renal vasc thrombus - HUS secondary to a Shiga toxin bacterial gastro - E.Coli or Shigella

Question 20

HUS sx

Answer 20

Anemia + kidney injury in a kid after a GI illness

Question 21

Risk factors for recurrent AOM

Answer 21

Lack of breastfeeding, smoke exposure, daycare

Question 22

Abnormality in Fragile X?

Answer 22

FMR1 gene - X linked dominant condition due to unstable CGG repeat

Question 23

Facial features of Fragile X

Answer 23

Long narrow face with prominent jaw, large ears and deep-set eyes, macroorchism may also be seen closer to puberty

Question 24

Starting ADHD med what do you need to consider

Answer 24

Heart problems/ congential deafness - need a screening ECG, seizures, unstable weight/ loss of weight, growth in children, head trauma

Question 25

Kallman’s syndrome features

Answer 25

Idiopathic hypogonad - absent secondary sex, but tall, infertility.

Question 26

Inheritance of huntingtons

Answer 26

Autosomal dominant

Question 27

Vit D levels test in deficiency

Answer 27

25-hydroxyvitamin D

Question 28

Tuberous Sclerosis presents with?

Answer 28

Seizure in kid, CT shows calcification in nodules around ventricles, fibrous growths of the nail fold

Question 29

Apnea of prematurity tx?

Answer 29

Caffiene - enteral

Question 30

Test for muscular dystrophy in children?

Answer 30

Creatine kinase

Question 31

VACTERL

Answer 31

Vertebral, anal, cardiac, Tracheoesophageal fistula, renal and limb abnormalities
- look for TEF (can’t advance an NG tube